Abstract
Acute pulmonary embolism (PE) is one of the serious complications with high mortality
after thoracic surgery. The authors aimed to determine the prevalence of PE events
and evaluate additional risk factors for PE in patients with lung cancer surgery.
Patients underwent lung cancer resections during January 2012 to July 2015 and had
30-day postoperative follow-up were included. Those with incomplete or miscoded data
were excluded. The number of postoperative PE events was recorded retrospectively.
Analyses were used to evaluate risk factors of PE during the hospitalization. The
authors reviewed 11,474 patients who underwent surgery for lung cancer. The overall
30-day incidence of PE after thoracic surgery at their institution was 0.53%. The
30-day PE incidence without chemical prophylaxis was 0.57% (55/9,726) and the mortality
rate was 10%. Multivariate analyses revealed that age over 66 (odds ratio [OR]: 1.09,
95% confidence interval [CI]: 1.05–1.12, p < 0.001), more extensive surgery than lobectomy (OR: 2.34, 95% CI: 1.28–4.25, p = 0.006) and stage IV of lung cancer (OR: 4.22, 95% CI: 1.50–11.9, p = 0.007) were associated with an increased risk of PE. Using these additional risk
factors, based on readily available clinical characteristics, can help to risk-stratify
patients and warrant extended chemical prophylaxis for patients to reduce the incidence
of acute PE.
Keywords
pulmonary embolism - thoracic surgery - lung cancer - chemical prophylaxis - risk
factor
